| Page (PDF) | 47 |
|---|---|
| Certificate Number | – |
| Name of Deceased | Waller, George |
| Place of Death | Somerset |
| Town of Death | Fairmount 306 |
| Sex | M |
| Race | Collord |
| Married, Widowed, or Single | Married |
| Date of Birth | Don't know |
| Age (year, month, days) | 75 yrs no mos |
| Occupation or Employer | Farmer |
| Birthplace | Somerset Co. |
| Father's Name | George Waller |
| Father's Birthplace | Fairmount, Md |
| Mother's Name | Fanny Selby |
| Mother's Birthplace | Fairmount, Md |
| Informant (Relationship and Address) | Emma Johnson, Upper Fairmount |
| Date of Death | 8/5/1912 |
| Cause of Death and Time Attended by Doctor | Delatation of Heart, 4 weeks |
| Immediate, Secondary, or Contributory Cause and How Long | Kidney trouble |
| Physician and Address | Edward S. Miles, M.D., Upper Fairmount, Md |
| Burial Place, Date, Undertaker, and Address | Church Cemetary 8/6/1912 H.L. Wilson undertaker, Upper Fairmount Md |
| Length of Residence, Where Disease Contracted, Former Residence | – |
| Other Notes | – |
If you are citing this record, please use the following format:
[Author (if known)], Maryland Death Certificates (Somerset, Wicomico, Worcester Counties), 1910-1922, [Date (if known)], Enduring Connections: Exploring Delmarva’s Black History, Nabb Research Center, Salisbury University.
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